**Core Concept**
Congestive heart failure (CHF) at birth can be a manifestation of underlying cardiac anomalies or conditions that compromise cardiac function in the neonatal period. In this context, the term "congestive failure" refers to signs of fluid overload and impaired cardiac output.

**Why the Correct Answer is Right**
The condition most likely to present with congestive failure at birth is **Hypoplastic Left Heart Syndrome (HLHS)**. HLHS is a congenital heart defect characterized by underdevelopment of the left ventricle, leading to impaired cardiac output and potential for fluid overload. The left ventricle is unable to pump enough blood to meet the body's needs, resulting in decreased systemic blood pressure and increased pulmonary blood flow. This can cause signs of congestive heart failure, such as tachypnea, tachycardia, and poor feeding.

**Why Each Wrong Option is Incorrect**
* **Option A:** While **Truncus Arteriosus** can lead to congestive heart failure, it typically presents with cyanosis and failure to thrive rather than congestive failure at birth.
* **Option B:** **Tetralogy of Fallot** primarily presents with cyanosis due to right-to-left shunting, rather than congestive heart failure.
* **Option C:** **Tricuspid Atresia** can lead to congestive heart failure, but it typically presents with cyanosis and failure to thrive rather than congestive failure at birth.

**Clinical Pearl / High-Yield Fact**
HLHS is often associated with a characteristic "boot-shaped" heart on chest X-ray due to the underdevelopment of the left ventricle.

**Correct Answer: C. Tricuspid Atresia**